Abstract
SummaryThe prevalence of childhood obesity is increasing at epidemic rates globally, with widening inequalities between advantaged and disadvantaged groups. Despite the promise of schools as a universal context to access and influence all children, the potential of school‐based interventions to positively impact children's physical activity behaviour, and obesity risk, remains uncertain. We searched six electronic databases to February 2017 for cluster randomized trials of school‐based physical activity interventions. Following data extraction, authors were sent re‐analysis requests. For each trial, a mean change score from baseline to follow‐up was calculated for daily minutes of accelerometer‐assessed moderate‐to‐vigorous physical activity (MVPA), for the main effect, by gender, and by socio‐economic position (SEP). Twenty‐five trials met the inclusion criteria; 17 trials provided relevant data for inclusion in the meta‐analyses. The pooled main effect for daily minutes of MVPA was nonexistent and nonsignificant. There was no evidence of differential effectiveness by gender or SEP. This review provides the strongest evidence to date that current school‐based efforts do not positively impact young people's physical activity across the full day, with no difference in effect across gender and SEP. Further assessment and maximization of implementation fidelity is required before it can be concluded that these interventions have no contribution to make.
Highlights
The worldwide prevalence of childhood obesity has increased tenfold over the past four decades.[1]
Physical inactivity is a key contributor to childhood obesity,[4] and international guidelines recommend that young people aged 5–18 years accumulate “at least 60 minutes of moderate‐to‐vigorous physical activity (MVPA) daily”
This review focused on a subset of the literature on physical activity promotion in young people: school‐based interventions
Summary
The worldwide prevalence of childhood obesity has increased tenfold over the past four decades.[1]. Children who are socioeconomically disadvantaged and girls are more likely to be physically inactive than children who are more advantaged and boys.[8,9] Promoting health equity by reducing inequalities in health behaviours is increasingly a priority for national and supranational bodies.[10]
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